Think steroids are the only thing that can get an athlete in trouble? You’d be wrong.
Dietary supplements, cosmetic treatments and recovery aids have all landed professional jocks in hot water with anti-doping authorities, costing them games, medals and reputations — sometimes without even realizing they’d crossed a line.
“I have absolutely seen athletes and support teams underestimate the risk of wellness products,” Dr. Mark Kovacs, a performance physiologist and coach who has worked with scores of professional athletes, told The Post.
“The surprise usually comes from the same belief: ‘I bought it legally, so I thought it was safe.’”
The biggest misconception, he said, is that doping is just about juicing or athletes deliberately trying to get an unfair edge. Today’s landscape is much bigger.
“It includes anabolic agents, peptide hormones, growth factors, beta-2 agonists, hormone and metabolic modulators, masking agents, stimulants, certain narcotics, cannabinoids, glucocorticoids in specific contexts, IV methods, blood manipulation and even gene or cell-related methods,” Kovacs said.
And ignorance is no get-out-of-jail-free card. Athletes who break the rules by accident can still find themselves watching from the sidelines.
“Athletes are subject to the principle of strict liability, meaning they are ultimately responsible for every substance they put into their bodies, regardless of intent,” said David Trosin, senior director of nutrition and wellness at NSF, a nonprofit that independently tests and certifies products.
“There have been cases where undeclared or prohibited substances in supplements have contributed to anti-doping violations, even when an athlete did not intend to use a banned substance.”
Just ask former NFL offensive tackle Taylor Lewan.
In 2019, the then-Tennessee Titan tested positive for ostarine, a drug that works similarly to anabolic steroids and is banned by the World Anti-Doping Agency (WADA) and major sports leagues, including the NFL.
Lewan maintained that he had accidentally ingested it through a supplement recommended by his doctors and nutritionists to protect his brain health on the field.
“I’ve never done anything knowingly that would cheat the game,” he said at a press conference at the time.
He even took — and reportedly passed — a third-party polygraph test to back up his claim.
But it wasn’t enough to spare him a four-game suspension.
What’s lurking in your supplement stack?
Kovacs said supplements can put athletes at risk in three main ways.
“First, the product may contain a prohibited ingredient that is listed under a different name,” he said. “Second, the product label may be inaccurate or incomplete. Third, the product may be contaminated during manufacturing, storage or distribution.”
The numbers are troubling. One study of 3,132 dietary supplements found that 875 — or 28% — had undeclared substances.
Another found that nearly 90% of sports supplements were inaccurately labeled, many spiked with illicit ingredients such as synthetic stimulants.
That’s a big problem when the vast majority of professional and elite athletes take at least one dietary supplement.
The US Anti-Doping Agency (USADA) has flagged muscle-building, weight-loss and energy products as particularly risky categories.
“Pre-workouts and weight-loss products are especially concerning because even when caffeine itself is not prohibited under WADA, those products may contain other stimulants or contaminants that are prohibited,” Kovacs said.
Paralympic track and field athlete Desmond Jackson knows about this firsthand.
In 2021, he was hit with a 14-month suspension by USADA after testing positive for dehydroepiandrosterone (DHEA), a banned drug.
Just 22 at the time, Jackson took an over-the-counter pill his coach said would boost his energy. He reportedly accepted it without asking questions.
Kovacs also flagged sexual-enhancement products as a particularly risky category.
Think “male enhancement” pills, libido boosters disguised as herbal blends and so-called performance gummies.
Olympic gold medalist sprinter LaShawn Merritt learned that lesson in 2010, receiving a 21-month suspension after failing three doping tests.
He blamed the positive tests on ExtenZe, an OTC sexual-enhancement product he bought at 7-Eleven. The product contained undeclared DHEA.
Looking back, Merritt called his mistake “foolish, immature and egotistical.”
A hairy situation
Even products seemingly miles away from performance enhancement can cause problems.
In 2006, US skeleton racer Zach Lund tested positive for finasteride, a prescription hair-loss medication.
Although he had disclosed taking the drug, WADA classified finasteride as a steroid-masking agent at the time.
Lund was removed from the 2006 Winter Olympics and suspended for one year by the Court of Arbitration for Sport.
In an ironic twist, he’s bald now — and finasteride is no longer on WADA’s banned list.
But hair-loss treatments are still causing headaches for athletes.
Last year, Athletic Club player Yeray Álvarez received a 10-month UEFA ban after testing positive for a prohibited substance linked to canrenone, a medication he had taken to prevent hair loss caused by treatment for testicular cancer.
Minefield at the med spa
Kovacs pointed to IV therapy as another “major area of concern.”
Once largely confined to specialized clinics, IV treatments delivering fluids, electrolytes, vitamins and minerals directly into the bloodstream have become a fixture at med spas.
“Many athletes think that if the IV contains legal vitamins or fluids, there is no anti-doping issue. That’s not true,” Kovacs warned.
“Under WADA rules, IV infusions or injections above 100 mL in a 12-hour period are prohibited unless they fall under specific medical exceptions.”
That’s because large-volume infusions can potentially mask prohibited substances by diluting an athlete’s blood or urine.
Olympic swimming legend Ryan Lochte ran afoul of the rules in 2018 after posting a photo of himself receiving an IV infusion — a move that cost him a 14-month suspension from WADA.
And the issue hasn’t gone away.
In August, track and field athlete Aleia Hobbs accepted six months of ineligibility after receiving a saline infusion exceeding the 100 mL limit in a 12-hour period while trying to treat flu-like symptoms at home.
Other med spa services can also trip athletes up, Kovacs warned.
“Traditional fillers or standard cosmetic procedures may not be an issue by themselves, but the concern is that many med spas now market services that overlap with anti-aging, hormone optimization, peptides, growth factors, stem cells and injectable recovery products,” he said.
Sprinter Tyson Gay learned that the hard way in 2014, accepting a one-year suspension after testing positive for a steroid and surrendering his Olympic silver medal.
ProPublica later reported that the steroid was believed to have come from a cream supplied by an anti-aging specialist.
The peptide problem
Experimental peptides are another growing concern. Many lack human research and FDA approval but are readily available online and through med spas.
Last year, triathlete Anthony McCauley accepted a four-year period of ineligibility after investigators found he had used banned substances, including BPC-157 and TB-500.
Sometimes called the “wolverine stack,” the synthetic peptide combination is promoted as a way to speed recovery from joint injuries and muscle tears.
McCauley also faced scrutiny for promoting the prohibited products online to followers, some of whom were subject to the World Anti-Doping Code.
How athletes can stay on the right side of the rules
“For elite athletes, the standard should be: food first, medical need second and supplements only when there is a clear reason, documentation and risk-reduction process,” Kovacs said.
“That means checking every ingredient, using only reputable third-party certified products when supplementation is necessary, saving batch and lot numbers, keeping photos of the label, documenting who recommended the product and checking WADA/USADA resources.”
One leader in the space is NSF, which runs its Certified for Sport program to screen supplements, personal care products and functional foods for more than 190 banned substances.
The program also verifies label accuracy and inspects manufacturing facilities.
It’s the only independent, third-party certification program recognized by USADA, MLB and the NHL and is recommended by the NFL, NBA, PGA and LPGA.
Its certification extends to some products in otherwise high-risk categories, including Thorne’s Women’s Libido Boost and 1st Phorm’s Megawatt Pre-Workout Powder. Nutrafol’s hair-growth supplements are also the only products of their kind to receive the nonprofit’s certification.
“The takeaway is that athletes need to think beyond ‘What am I taking?’ They need to ask, ‘What is being applied to me? What is being injected? What is in the IV? What is my therapist using? What is my med spa using? What is my supplement manufacturer actually putting in this product?’ ” Kovacs said.
“That is the level of diligence required in modern sport.”
